Single-Center Experience with Lung Transplant Evaluation Referrals of Acute Respiratory Distress Syndrome Patients during the COVID-19 Pandemic: How Do You Make Up for Lost Time?

Emily J. Cerier, Takahide Toyoda, Colleen McNulty, Anne O'Boye, Chitaru Kurihara, Ankit Bharat, Nandita R. Nadig*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

Transfer of select, medically refractory acute respiratory distress syndrome patients to lung transplant centers requires extensive resources. Here, we report 270 consecutive lung transplant patient referrals to our center for medically refractory ARDS from June 2021 to April 2022, following the implementation of clinical care pathways for intake of these patients. Eighty-seven of 270 patients (32.2%) met screening criteria and were evaluated for transfer within a median of 12 days, during which 38 of 87 patients (43.7%) died and 12 of 87 patients (13.8%) transferred elsewhere. Thirty-seven of 87 patients (42.5%) were accepted for transfer of which 16 of 37 patients (43.2%) successfully transferred to our center with a median transfer waiting period of 12 days. Because of resource constraints, 21 of 37 accepted patients (56.8%) could not be transferred of which 9 of 21 patients (42.9%) died while waiting. Nine of 16 transferred patients (56.2%) eventually underwent lung transplantation with over 80% 6-month survival. ARDS patients referred for transplantation have high risk of mortality and, therefore, require well-described pathways for evaluation and transfer.

Original languageEnglish (US)
Pages (from-to)E0965
JournalCritical Care Explorations
Volume5
Issue number9
DOIs
StatePublished - Sep 7 2023

Funding

Dr. Cerier is supported by the National Institute of Health Grant T32AI083216 and a grant from the Thoracic Surgery Foundation. Dr. Bharat is supported by the National Institutes of Health Grants: HL145478, HL147290, and HL147575. The remaining authors have not disclosed any potential conflicts of interest.

Keywords

  • acute respiratory distress syndrome
  • hospital transfer
  • intensive care unit
  • lung transplantation
  • quality improvement

ASJC Scopus subject areas

  • Critical Care and Intensive Care Medicine

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